血清乳酸脱氢酶与转移性胃癌姑息性化疗患者生存期的关系  

The relationship between serum lactate dehydrogenase and survival time in metastatic gastric cancer patients who received palliative chemotherapy

作　　者：罗旭[1] 王千千[1] 党会芬 王玉凤[1] 田迎霞[1] Luo Xu;Wang Qianqian;Dang Huifen;Wang Yufeng;Tian Yingxia(Department of Oncology,Gansu Provincial Cancer Hospital,Lanzhou 730050,China)

机构地区：[1]甘肃省肿瘤医院肿瘤内科,甘肃兰州730050

出　　处：《兰州大学学报（医学版）》2023年第3期39-45,共7页Journal of Lanzhou University（Medical Sciences）

基　　金：国家自然科学基金资助项目(82060535);兰州市科技发展指导性计划资助项目(2019-ZD-137)。

摘　　要：目的 观察转移性胃癌姑息性化疗患者血清乳酸脱氢酶(LDH)水平与总生存期(OS)、无进展生存期(PFS)的关系。方法 回顾性分析甘肃省肿瘤医院2016年1月-2021年1月期间收治的69例转移性胃癌患者接受姑息性化疗的临床资料,查阅、整理住院病历,收集患者化疗前血清LDH水平、疾病进展及转归情况,分析患者化疗前血清LDH水平与OS、PFS的关系。结果 受试者工作特征曲线分析显示:化疗前血清LDH水平预测转移性胃癌死亡的曲线下面积为0.73 (P <0.05,95%CI:[0.612,0.847]),特异度为92.9%,灵敏度为63.6%。化疗前血清LDH升高患者的OS、PFS均短于LDH正常患者(P <0.05),具有统计学意义。多因素Cox分析结果显示,化疗前血清LDH、糖类抗原CA72-4水平是转移性胃癌患者OS的独立危险因素(P <0.05),化疗疗效、D-二聚体是转移性胃癌患者PFS的独立危险因素(P<0.05)。结论 化疗前血清LDH升高的转移性胃癌姑息性化疗患者OS及PFS均短于LDH正常者。化疗前血清LDH水平可初步预测转移性胃癌姑息性化疗患者的预后。Objective The purpose of this study was to observe the relationship between serum lactate dehydrogenase(LDH)levels and survival time(OS and PFS)in patients with metastatic gastric cancer who had received palliative chemotherapy.Methods The clinical data of 69 patients with metastatic gastric cancer who had received palliative chemotherapy at Gansu Provincial Cancer Hospital between January 2016 and January 2021 were analyzed retrospectively.The medical data of the inpatients were collected and reviewed,as were the levels of LDH before chemotherapy and data on disease progression and death.The relationship between OS/PFS and LDH levels was then statistically examined.Results A receiver operator characteristic curve(ROC)analysis showed that the area under the curve of the level LDH before chemotherapy for the prediction of metastatic gastric cancer death was 0.73(P<0.05),with 92.9%specificity and 63.6%sensitivity.Patients with elevated serum LDH had a significantly shorter OS and PFS than those with normal LDH(P<0.05).Multi-factor Cox analysis revealed that LDH,CA72-4 and therapeutic efficacy were independent influencing factors of OS in patients with metastatic gastric cancer(P<0.05),while therapeutic efficacy and D-dimer were independent influencing factors of PFS (P< 0.05). Conclusion Patients with metastatic gastric cancer who hadreceived palliative chemotherapy had a poor prognosis if their lactate dehydrogenase level increased beforechemotherapy and their OS and PFS were shorter than those with normal LDH. The level of LDH beforechemotherapy could help predict the prognosis of patients with metastatic gastric cancer who had receivedpalliative chemotherapy.

关 键 词：乳酸脱氢酶 转移性胃癌 姑息性化疗 生存期 预后分析 

分 类 号：R735.2[医药卫生—肿瘤]